• Cari Malcolm and Katherine Knighting.
• School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK.
• Palliat Med. 2021 Sep 1; 35 (8): 1602-1611.

BackgroundEnd-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home.AimTo explore the value and assess the effectiveness of an innovative model of care providing home-based, end-of-life care as perceived by families who accessed the service.DesignA qualitative descriptive study design was employed with in-depth semi-structured interviews conducted with bereaved parents.Setting/ParticipantsThirteen bereaved parents of 10 children supported by the home-based end-of-life care service.ResultsParents reported effective aspects of end-of-life care provided at home to include: (1) ability to facilitate changes in preferred place of death; (2) trusted relationships with care providers who really know the child and family; (3) provision of child and family-centred care; (4) specialist care and support provided by the service as and when needed; and (5) quality and compassionate death and bereavement care. Parents proposed recommendations for future home-based end-of-life care including shared learning, improving access to home-based care for other families and dispelling hospice myths.ConclusionParents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.

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